The etiology of uterine sarcomas: a pooled analysis of the epidemiology of endometrial cancer consortium

A. S. Felix; L. S. Cook; M. M. Gaudet; T. E. Rohan; L. J. Schouten; V. W. Setiawan; L. A. Wise; K. E. Anderson; L. Bernstein; I. De Vivo; C. M. Friedenreich; S. M. Gapstur; R. A. Goldbohm; B. Henderson; P. L. Horn-Ross; L. Kolonel; J. V. Lacey; X. Liang; J. Lissowska; A. Magliocco; M. L. McCullough; A. B. Miller; S. H. Olson; J. R. Palmer; Y. Park; A. V. Patel; J. Prescott; R. Rastogi; K. Robien; L. Rosenberg; C. Schairer; X. Ou Shu; P. A. van den Brandt; R. A. Virkus; N. Wentzensen; Y-B Xiang; W-H Xu; H. P. Yang; L. A. Brinton

doi:10.1038/bjc.2013.2

The etiology of uterine sarcomas: a pooled analysis of the epidemiology of endometrial cancer consortium

A. S. Felix^*, L. S. Cook, M. M. Gaudet, T. E. Rohan, L. J. Schouten, V. W. Setiawan, L. A. Wise, K. E. Anderson, L. Bernstein, I. De Vivo, C. M. Friedenreich, S. M. Gapstur, R. A. Goldbohm, B. Henderson, P. L. Horn-Ross, L. Kolonel, J. V. Lacey, X. Liang, J. Lissowska, A. MaglioccoM. L. McCullough, A. B. Miller, S. H. Olson, J. R. Palmer, Y. Park, A. V. Patel, J. Prescott, R. Rastogi, K. Robien, L. Rosenberg, C. Schairer, X. Ou Shu, P. A. van den Brandt, R. A. Virkus, N. Wentzensen, Y-B Xiang, W-H Xu, H. P. Yang, L. A. Brinton

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: Uterine sarcomas are characterised by early age at diagnosis, poor prognosis, and higher incidence among Black compared with White women, but their aetiology is poorly understood. Therefore, we performed a pooled analysis of data collected in the Epidemiology of Endometrial Cancer Consortium. We also examined risk factor associations for malignant mixed mullerian tumours (MMMTs) and endometrioid endometrial carcinomas (EECs) for comparison purposes. Methods: We pooled data on 229 uterine sarcomas, 244 MMMTs, 7623 EEC cases, and 28 829 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) for risk factors associated with uterine sarcoma, MMMT, and EEC were estimated with polytomous logistic regression. We also examined associations between epidemiological factors and histological subtypes of uterine sarcoma. Results: Significant risk factors for uterine sarcoma included obesity (body mass index (BMI) >= 30 vs BMI <25 kg m(-2) (OR: 1.73, 95% CI: 1.22-2.46), P-trend = 0.008) and history of diabetes (OR: 2.33, 95% CI: 1.41-3.83). Older age at menarche was inversely associated with uterine sarcoma risk (>= 15 years vs <11 years (OR: 0.70, 95% CI: 0.34-1.44), P-trend: 0.04). BMI was significantly, but less strongly related to uterine sarcomas compared with EECs (OR: 3.03, 95% CI: 2.82-3.26) or MMMTs (OR: 2.25, 95% Cl: 1.60-3.15, P-heterogeneity = 0.01). Conclusion: In the largest aetiological study of uterine sarcomas, associations between menstrual, hormonal, and anthropometric risk factors and uterine sarcoma were similar to those identified for EEC. Further exploration of factors that might explain patterns of age- and race-specific incidence rates for uterine sarcoma are needed.

Original language	English
Pages (from-to)	727-734
Journal	British Journal of Cancer
Volume	108
Issue number	3
DOIs	https://doi.org/10.1038/bjc.2013.2
Publication status	Published - 19 Feb 2013

Keywords

risk factors
uterine sarcoma
pooled analysis
obesity
diabetes

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Cite this

Felix, A. S., Cook, L. S., Gaudet, M. M., Rohan, T. E., Schouten, L. J., Setiawan, V. W., Wise, L. A., Anderson, K. E., Bernstein, L., De Vivo, I., Friedenreich, C. M., Gapstur, S. M., Goldbohm, R. A., Henderson, B., Horn-Ross, P. L., Kolonel, L., Lacey, J. V., Liang, X., Lissowska, J., ... Brinton, L. A. (2013). The etiology of uterine sarcomas: a pooled analysis of the epidemiology of endometrial cancer consortium. British Journal of Cancer, 108(3), 727-734. https://doi.org/10.1038/bjc.2013.2

@article{1891180b5ff9480c841a6d0d6e3c3e76,

title = "The etiology of uterine sarcomas: a pooled analysis of the epidemiology of endometrial cancer consortium",

abstract = "Background: Uterine sarcomas are characterised by early age at diagnosis, poor prognosis, and higher incidence among Black compared with White women, but their aetiology is poorly understood. Therefore, we performed a pooled analysis of data collected in the Epidemiology of Endometrial Cancer Consortium. We also examined risk factor associations for malignant mixed mullerian tumours (MMMTs) and endometrioid endometrial carcinomas (EECs) for comparison purposes. Methods: We pooled data on 229 uterine sarcomas, 244 MMMTs, 7623 EEC cases, and 28 829 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) for risk factors associated with uterine sarcoma, MMMT, and EEC were estimated with polytomous logistic regression. We also examined associations between epidemiological factors and histological subtypes of uterine sarcoma. Results: Significant risk factors for uterine sarcoma included obesity (body mass index (BMI) >= 30 vs BMI <25 kg m(-2) (OR: 1.73, 95% CI: 1.22-2.46), P-trend = 0.008) and history of diabetes (OR: 2.33, 95% CI: 1.41-3.83). Older age at menarche was inversely associated with uterine sarcoma risk (>= 15 years vs <11 years (OR: 0.70, 95% CI: 0.34-1.44), P-trend: 0.04). BMI was significantly, but less strongly related to uterine sarcomas compared with EECs (OR: 3.03, 95% CI: 2.82-3.26) or MMMTs (OR: 2.25, 95% Cl: 1.60-3.15, P-heterogeneity = 0.01). Conclusion: In the largest aetiological study of uterine sarcomas, associations between menstrual, hormonal, and anthropometric risk factors and uterine sarcoma were similar to those identified for EEC. Further exploration of factors that might explain patterns of age- and race-specific incidence rates for uterine sarcoma are needed.",

keywords = "risk factors, uterine sarcoma, pooled analysis, obesity, diabetes",

author = "Felix, {A. S.} and Cook, {L. S.} and Gaudet, {M. M.} and Rohan, {T. E.} and Schouten, {L. J.} and Setiawan, {V. W.} and Wise, {L. A.} and Anderson, {K. E.} and L. Bernstein and {De Vivo}, I. and Friedenreich, {C. M.} and Gapstur, {S. M.} and Goldbohm, {R. A.} and B. Henderson and Horn-Ross, {P. L.} and L. Kolonel and Lacey, {J. V.} and X. Liang and J. Lissowska and A. Magliocco and McCullough, {M. L.} and Miller, {A. B.} and Olson, {S. H.} and Palmer, {J. R.} and Y. Park and Patel, {A. V.} and J. Prescott and R. Rastogi and K. Robien and L. Rosenberg and C. Schairer and Shu, {X. Ou} and {van den Brandt}, {P. A.} and Virkus, {R. A.} and N. Wentzensen and Y-B Xiang and W-H Xu and Yang, {H. P.} and Brinton, {L. A.}",

year = "2013",

month = feb,

day = "19",

doi = "10.1038/bjc.2013.2",

language = "English",

volume = "108",

pages = "727--734",

journal = "British Journal of Cancer",

issn = "0007-0920",

publisher = "Nature Publishing Group",

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Felix, AS, Cook, LS, Gaudet, MM, Rohan, TE, Schouten, LJ, Setiawan, VW, Wise, LA, Anderson, KE, Bernstein, L, De Vivo, I, Friedenreich, CM, Gapstur, SM, Goldbohm, RA, Henderson, B, Horn-Ross, PL, Kolonel, L, Lacey, JV, Liang, X, Lissowska, J, Magliocco, A, McCullough, ML, Miller, AB, Olson, SH, Palmer, JR, Park, Y, Patel, AV, Prescott, J, Rastogi, R, Robien, K, Rosenberg, L, Schairer, C, Shu, XO, van den Brandt, PA, Virkus, RA, Wentzensen, N, Xiang, Y-B, Xu, W-H, Yang, HP & Brinton, LA 2013, 'The etiology of uterine sarcomas: a pooled analysis of the epidemiology of endometrial cancer consortium', British Journal of Cancer, vol. 108, no. 3, pp. 727-734. https://doi.org/10.1038/bjc.2013.2

TY - JOUR

T1 - The etiology of uterine sarcomas: a pooled analysis of the epidemiology of endometrial cancer consortium

AU - Felix, A. S.

AU - Cook, L. S.

AU - Gaudet, M. M.

AU - Rohan, T. E.

AU - Schouten, L. J.

AU - Setiawan, V. W.

AU - Wise, L. A.

AU - Anderson, K. E.

AU - Bernstein, L.

AU - De Vivo, I.

AU - Friedenreich, C. M.

AU - Gapstur, S. M.

AU - Goldbohm, R. A.

AU - Henderson, B.

AU - Horn-Ross, P. L.

AU - Kolonel, L.

AU - Lacey, J. V.

AU - Liang, X.

AU - Lissowska, J.

AU - Magliocco, A.

AU - McCullough, M. L.

AU - Miller, A. B.

AU - Olson, S. H.

AU - Palmer, J. R.

AU - Park, Y.

AU - Patel, A. V.

AU - Prescott, J.

AU - Rastogi, R.

AU - Robien, K.

AU - Rosenberg, L.

AU - Schairer, C.

AU - Shu, X. Ou

AU - van den Brandt, P. A.

AU - Virkus, R. A.

AU - Wentzensen, N.

AU - Xiang, Y-B

AU - Xu, W-H

AU - Yang, H. P.

AU - Brinton, L. A.

PY - 2013/2/19

Y1 - 2013/2/19

N2 - Background: Uterine sarcomas are characterised by early age at diagnosis, poor prognosis, and higher incidence among Black compared with White women, but their aetiology is poorly understood. Therefore, we performed a pooled analysis of data collected in the Epidemiology of Endometrial Cancer Consortium. We also examined risk factor associations for malignant mixed mullerian tumours (MMMTs) and endometrioid endometrial carcinomas (EECs) for comparison purposes. Methods: We pooled data on 229 uterine sarcomas, 244 MMMTs, 7623 EEC cases, and 28 829 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) for risk factors associated with uterine sarcoma, MMMT, and EEC were estimated with polytomous logistic regression. We also examined associations between epidemiological factors and histological subtypes of uterine sarcoma. Results: Significant risk factors for uterine sarcoma included obesity (body mass index (BMI) >= 30 vs BMI <25 kg m(-2) (OR: 1.73, 95% CI: 1.22-2.46), P-trend = 0.008) and history of diabetes (OR: 2.33, 95% CI: 1.41-3.83). Older age at menarche was inversely associated with uterine sarcoma risk (>= 15 years vs <11 years (OR: 0.70, 95% CI: 0.34-1.44), P-trend: 0.04). BMI was significantly, but less strongly related to uterine sarcomas compared with EECs (OR: 3.03, 95% CI: 2.82-3.26) or MMMTs (OR: 2.25, 95% Cl: 1.60-3.15, P-heterogeneity = 0.01). Conclusion: In the largest aetiological study of uterine sarcomas, associations between menstrual, hormonal, and anthropometric risk factors and uterine sarcoma were similar to those identified for EEC. Further exploration of factors that might explain patterns of age- and race-specific incidence rates for uterine sarcoma are needed.

AB - Background: Uterine sarcomas are characterised by early age at diagnosis, poor prognosis, and higher incidence among Black compared with White women, but their aetiology is poorly understood. Therefore, we performed a pooled analysis of data collected in the Epidemiology of Endometrial Cancer Consortium. We also examined risk factor associations for malignant mixed mullerian tumours (MMMTs) and endometrioid endometrial carcinomas (EECs) for comparison purposes. Methods: We pooled data on 229 uterine sarcomas, 244 MMMTs, 7623 EEC cases, and 28 829 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) for risk factors associated with uterine sarcoma, MMMT, and EEC were estimated with polytomous logistic regression. We also examined associations between epidemiological factors and histological subtypes of uterine sarcoma. Results: Significant risk factors for uterine sarcoma included obesity (body mass index (BMI) >= 30 vs BMI <25 kg m(-2) (OR: 1.73, 95% CI: 1.22-2.46), P-trend = 0.008) and history of diabetes (OR: 2.33, 95% CI: 1.41-3.83). Older age at menarche was inversely associated with uterine sarcoma risk (>= 15 years vs <11 years (OR: 0.70, 95% CI: 0.34-1.44), P-trend: 0.04). BMI was significantly, but less strongly related to uterine sarcomas compared with EECs (OR: 3.03, 95% CI: 2.82-3.26) or MMMTs (OR: 2.25, 95% Cl: 1.60-3.15, P-heterogeneity = 0.01). Conclusion: In the largest aetiological study of uterine sarcomas, associations between menstrual, hormonal, and anthropometric risk factors and uterine sarcoma were similar to those identified for EEC. Further exploration of factors that might explain patterns of age- and race-specific incidence rates for uterine sarcoma are needed.

KW - risk factors

KW - uterine sarcoma

KW - pooled analysis

KW - obesity

KW - diabetes

U2 - 10.1038/bjc.2013.2

DO - 10.1038/bjc.2013.2

M3 - Article

C2 - 23348519

SN - 0007-0920

VL - 108

SP - 727

EP - 734

JO - British Journal of Cancer

JF - British Journal of Cancer

IS - 3

ER -